State Approves 267 Wake County Hospital Beds; County Transfers Over 12 Acres

State regulators at the North Carolina Department of Health and Human Services Certificate of Need office approved a total of 267 additional acute-care beds for Wake County health systems in decisions released earlier this month, far below the 644 beds the systems requested. The approvals concentrated beds at WakeMed’s Raleigh main campus, Duke Raleigh Hospital, and UNC Health Rex in Raleigh, while multiple new-hospital requests and satellite expansions were denied.

WakeMed’s Raleigh main campus received approval for 164 acute-care beds with an estimated capital cost just under $430 million and an expected completion date of October 2032. Duke Raleigh Hospital won approval for 52 beds with a capital cost estimate of $29 million. UNC Health Rex was approved for 51 beds with an estimated capital expenditure of $98.4 million and a projected completion date of November 2030.

Several high-profile proposals were rejected. WakeMed’s request for 25 beds at WakeMed North was denied; that project had an estimated cost of $28 million and a proposed October 2029 completion date. A separate WakeMed request for 78 beds at a new Garner hospital was denied; that proposal carried an estimated $272.5 million price tag with a planned October 2028 completion. Duke’s request for 120 beds at a future West Cary hospital was denied; that project was estimated at about $1.2 billion and was scheduled to open in 2027. UNC’s proposal for a new 50-bed hospital in Wake Forest was denied for a second time; that plan listed estimated costs of $485.5 million and a July 2031 completion date. Novant Health’s scaled-back 26-bed Knightdale proposal, with a near $255 million estimate and a targeted January 2030 opening, was also denied.

Local reporting from October 2025 adds complexity to the Garner picture. WTVD reported that NCDHHS had approved a 45-bed acute-care hospital to complement the WakeMed Garner Healthplex around 2023 and quoted WakeMed president and CEO Donald Gintzig saying, “We are bringing transformative care to our community with this unique campus, and we are so fortunate to now be able to move forward with the design and construction process in unison.” WTVD also quoted Garner resident Wayne Brasch saying, “A full trauma one type center that has E.R. and state of the art medical care would benefit all these folks that are moving to this area. I would support that.” The recent denials mean project sponsors and NCDHHS will need to clarify whether those earlier approvals and the denied filings describe different phases or separate applications.

Separately, the Wake County Board of Commissioners approved transferring more than 12 acres of county-owned land to Wake Technical Community College and WakeMed to support a Health and Education District in Raleigh. County materials say master planning began in 2022, an MOU coordinating Wake County, Wake Tech and WakeMed was signed in 2023, and the City of Raleigh rezoned the area to a Campus Master Plan district in October 2024. Wake Tech President Dr. Scott Ralls called the transfer “the catalyst for a new era of healthcare training in Wake County. It paves the way for a new state-of-the-art simulation hospital that will equip more healthcare professionals and allows for future opportunities to serve our growing communities.” Wake Tech and WakeMed have committed to fund construction and maintenance of a road extension connecting the campuses, and Wake County says its new Public Health Center within the district is nearing completion.

The CON rulings and the county land transfer reshape workforce and access plans across the Triangle. Business reporting earlier this cycle noted UNC projected a new hospital could employ more than 500 people and quoted Kirsten Riggs, interim president of UNC Health Rex, on the intent to “meet the growing healthcare needs of our community and begin to alleviate our current capacity constraints.” Duke Health told local Eyewitness News it is “working to bring an outpatient care campus to Garner over the next couple of years, which could include primary and specialty care, ambulatory surgery, and emergency care.” Wake County’s release describes the transferred land as being permanently dedicated to educational or community hospital use, but the county did not specify the exact acreage beyond “more than 12 acres” in the release.